Symptoms of the lumbar spine | Symptoms of spinal canal stenosis

Symptoms of the lumbar spine

The lumbar spine is the area where spinal canal stenosis develops most frequently. The main symptom here is pain in the legs and back. These are load-dependent and usually occur when walking a certain distance or when standing for a long time.

It is also typical that the symptoms are relieved or disappear completely when the hip is bent, for example when sitting or when the upper body is bent forward. Those affected often report that the pain begins particularly when walking downhill, whereas walking uphill causes less discomfort. In addition, many patients can often still ride a bicycle without any problems despite pain-related restrictions on the walking distance, since the upper body is also inclined.

In this position, the spinal canal is less constricted and the symptoms of stenosis do not occur. The symptoms described above are also known as intermittent claudication of the spinal canal.Although this is typical for spinal stenosis of the lumbar spine, it does not occur in every patient with the disease. A further distinction is the equally common “shop window disease”, which is caused by a circulatory disorder of the legs.

Here too, the walking distance is usually limited due to the onset of pain. While in this disease, stopping usually leads to a reduction in pain, a patient with spinal canal stenosis often has to sit down for the symptoms to subside. In some cases, spinal canal stenosis of the lumbar spine causes not only pain but also symptoms of leg failure. The most frequent symptoms are sensations or numbness, which can affect the entire leg and genital area. Only in extremely rare cases can paralysis even occur as a symptom of a pronounced spinal stenosis of the lumbar spine.

What are the minimum symptoms for surgery?

In some cases, spinal stenosis can be so severe that the symptoms cannot be sufficiently relieved by all conservative measures including highly effective painkillers. In cases where severe pain persists for months and is constantly increasing, surgical widening of the spinal canal may therefore be considered as a last resort. This option becomes particularly relevant if it can prevent imminent severe nerve damage.

This can manifest itself, for example, in numbness that does not only occur under stress. Symptoms of paralysis and loss of control over bladder and rectum function can also be symptoms of pronounced nerve damage, which could benefit from timely surgery. However, it must always be remembered that surgery for spinal stenosis carries many risks and complications occur in approximately one in five cases.

Before such a serious intervention, it is therefore important to weigh up the possible benefits and risks together with the physicians. In addition to the degree of suffering, the decision should also take into account age and life expectancy as well as possible concomitant diseases. Furthermore, there is no scientific evidence that patients over 65 years of age with spinal canal stenosis benefit from surgery at all.